For nearly a decade the programming of the only tool available for women to initiate safe sex has been dogged by maladministration, procurement troubles and difficulties in social marketing a product whose supply is erratic at best. The advocacy landscape around the female condom has changed significantly and is this year expected to focus on a key component of programming that is often overlooked, that of logistics management.

However, the situation should be seen in its rightful context. Last year, South Africa was on the verge of seeing 11 million unqualified female condoms being distributed by the Department of Health. After urgent intervention, the final tender was awarded to Sekunjalo Investments for the supply of the FC2 female condom. An important aspect to consider is that the second generation female condom remains the only World Health Organisation (WHO) prequalified female condom in the world, just like its predecessor, the FC1. The intensive prequalification process ensures that when the female condom does arrive in villages and towns across the country, women and men who rely on it to protect themselves from HIV, as well as the NGOs and agencies that market this product can rest assured that they are using/marketing a product whose quality cannot be called into doubt. Tender challenges and legal battles in this context only serve to suffocate the already stretched demand on the meager quantities that we bring into the country each year. This year so far, five million FC2 female condoms have been brought into South Africa and it is expected that this supply will be depleted by mid-2012. As yet there is no clear plan to ensure continuity in supply.

Demonstrating Demand

The issue of demand has long been a bug bear of female condom advocacy. The answer is simple, how can you demonstrate demand in absence of a sustainable supply? How do you demonstrate demand in a context where the communities trust in your work has been compromised after you marketed an amazing HIV prevention tool to them, only for them to find out that their local clinic has run out of stock? As a feminist, I would ask, why were the same questions not asked with the same level of intensity when it came to the male condom? Patriarchy is powerful you see, a firm ally at our side as we continue the valiant struggle to sideline the sexual, pleasure and reproductive health rights of women in South Africa. Practically, government will currently only procure FC2 quantities based on ‘demand’. The challenge is, that unless the logistics management system,  local AIDS councils and civil society networks are functional and effective, feeding statistics and usage data into the national government machinery, then female condom programming is dead in the water, effectively ensuring that we will never generate the quality and quantity of data needed to demonstrate the ever elusive demand. This deprives us of the data we need for effective evidence based advocacy and most importantly it means that we procure female condoms in a manner that does not relate to the epidemic in general and the specific needs of communities who use the female condom.

Men as Partners

The identification of men as partners in female condom programming by visionary organisations such as Limpopo’s Thohoyandou Victim Empowerment Programme has been identified as a key factor in making or breaking a sustainable social marketing intervention. Once again the ugly reality of misogyny and patriarchy ensure that the majority of decisions taken on safe sex rest with the male partner. This presents us with an opportunity to not only convince the male partner of the pleasurable, lifesaving, benefits of the female condom but to ensure that his experience with the female condom is one that he tells his friends about as well.

Just one part of the HIV Prevention basket!

The importance of getting female condom programming ‘right’ is not a selfish means to an end but forms the bedrock of how we programme existing and potential HIV prevention options such as lubrication, rectal and vaginal microbicides. The strengthening of government reporting mechanisms, local AIDS councils and civil society networks all contribute to a sustainable, effective, accountable female condom programme, that when taken hand in hand with male condom programming serve to expand the basket of accessible prevention options for all who need them.

What can you do this STI & Condom week?

1. Try using a Female Condom if you haven’t already. When you do use it, ask your partner to insert it for you – foreplay can be fun!
2. The FC2 is pre-lubricated and ready for use!
3. If you can’t find one, send me an email and let me know!
4. You can find out more about Rectal Microbicides at www.rectalmicrobicides.org
5. Join ‘The Pleasure Project’ on Facebook for always new, sexy ways to spice up your safe sex life! While safer sex and HIV prevention programmes are negative and disease-focused, The Pleasure Project is different: we take a positive, liberating and sexy approach to safer sex. Think of it as sex education … with the emphasis on ‘sex’ J. We aim to make sex safer by addressing one of the major reasons people have sex: the pursuit of pleasure.

Have you used a Female Condom? For an informative video on using the FC2 Female Condom you can go to: http://www.youtube.com/watch?v=0OUguv0JICQ.

– Tian Johnson is an advisor to SUPPORT Worldwide, a division of the Female Health Company and the founder of the African Alliance for HIV Prevention.